Technique Development for a Polytrauma Model to Study Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (P-REBOA) in Swine (Sus scrofa)
Abstract
Introduction: A reproducible, lethal non-compressible torso hemorrhage (NCTH) model is of importance to civilian and military trauma research. Current large animal models fail to balance clinical applicability with standardization and internal validity. As such, large animal models of trauma vary widely in literature, limiting comparisons. Methods: Yorkshire-cross swine were anesthetized, instrumented, and splenectomized. A simple liver tourniquet was applied prior to injury to prevent unregulated hemorrhage while creating a traumatic amputation of 30% of the liver. Release of the tourniquet and rapid abdominal closure following injury provided a standardized reference point for the onset and duration of uncontrolled hemorrhage. At the moment of death, the liver tourniquet was quickly reapplied to provide accurate quantification of intra-abdominal blood loss. Weight and volume of the resected and residual liver segments were measured. Hemodynamic parameters were recorded continuously throughout the experiment. Results: This liver injury was rapidly and universally lethal (11.2 +/- 4.9 min). The volume of hemorrhage (35.8 6 of total blood volume), and severity of uncontrolled hemorrhage (100% of animals deteriorated to a sustained MAP<35mmHg for 5 minutes) were consistent across all animals. Use of the tourniquet effectively halted pre- and post- procedure blood loss allowing for accurate quantification of amount of hemorrhage over a defined period. Additionally, the tourniquet facilitated the creation of a consistent liver resection weight by body weight ratio (0.0043 +/- 0.0003) and as a percentage of total liver resection volume (27% +/- 2.2%).Conclusion: This novel tourniquet-assisted NCTH model creates a standardized, reproducible, highly lethal, and clinically applicable injury in swine. Use of the tourniquet allowed for consistent liver injury and precise control over hemorrhage.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2016
- Accession Number
- AD1024018
Entities
People
- Lucas Neff
Organizations
- David Grant USAF Medical Center